MRI在产前胎儿颅脑病变中的诊断价值及影像特征

目的探讨胎儿颅脑病变的MRI特征以及临床诊断价值。方法回顾性分析89例胎儿颅脑病变的临床及影像资料,观察病灶部位、范围、信号特征、脑室及周围结构、是否合并其他中枢神经系统异常。以胎儿临床随访结果为金标准,比较分析MRI和US的诊断效果以及影像特征。结果MRI检出率为100%(89/89),47例为脑损伤改变,其中40例胎儿颅内出血,20例胎儿胼胝体发育异,10例Dandy-Walker畸形,5例蛛网膜囊肿,2例脑裂畸形,1例无脑回畸形,1例巨脑回畸形,3例脑穿通畸形。US检出率为64%(57/89)。24例脑损伤改变,16例胼胝体完全缺如,10例Dandy-Walker畸形,5例蛛网膜囊肿,1例胎儿脑裂畸形,1例脑穿通畸形。结论产前MRI可清晰显示颅脑病变的部位、范围及合并其他中枢神经系统异常,检出率高于超声,MRI及US联合检查有助于更准确、更早的发现病变并做出诊断,对早期干预具有重要的意义。

Diagnostic Value and Imaging Features of MRI in Prenatal Fetal Craniocerebral Disease

Objective Toexplore MRI features and clinical diagnostic value of fetal craniocerebral lesions.Methods Clinical and imaging data of 89 cases of fetal craniocerebral diseases were analyzed retrospectively,and the site,range,signal features,ventricles and peripheral structures were observed,and other central nervous system abnormalities were observed.The diagnostic results and imaging features of MRI and US were compared and analyzed using the gold standard of fetal clinical follow-up.Results MRI detection rate was 100%(89/89).There were 47 cases of brain damage changes,including 40 cases of fetal intracranial hemorrhage,20 cases of fetal corpus callosum dysplasia,10 cases of dandy-walker malformation,5 cases of arachnoid cyst,2 cases of cleft brain malformation,1 case of anencephaly,1 case of macrocephaly,and 3 cases of cerebral perforation malformation.The US detection rate is 64%(57/89).There were 24 cases of brain damage changes,16 cases of complete absence of corpus callosum,10 cases of dandy-walker deformity,5 cases of arachnoid cyst,1 case of fetal cleft deformity and 1 case of peritoneal deformity.Conclusion Prenatal MRI can clearly show the location,range of craniocerebral lesions and other central nervous system abnormalities,and the detection rate is higher than that of ultrasound.The combined examination can detect and diagnose more accurately and earlier,which is of great significance for clinical evaluation of prognosis and guidance of early intervention.